Background:
Allergic Rhinitis (AR) is a worldwide spread illness having an important impact on social life, sleep quality, school, and work productivity and huge direct and indirect costs. Patient preference is becoming an important aspect in medical care. ISMAR was designed as the first-over global survey to identify differences in attitudes and preference in patients and physicians about AR. ISMAR 2 is the second phase.
Methods:
ISMAR is an international, multicenter, non-interventional, cross-sectional study conducted in adults and children (≥ 6 years) with physician diagnosis-AR of at least 1 year of duration. Physicians recruited consecutive patients to whom the ISMAR questionnaire was administered. The study data collection was performed during a single visit. Other 2 additional documents (the investigator's questionnaire and Case Record Form) were also filled in. Statistical analysis was descriptive. For statistical inferences, Student t or Wilcoxon tests were performed according to the variables normality. Herein we are showing the patient's view.
Results:
A total of 2300 patients (2298 were analysed) included in 5 new countries and in new centres in 4 countries that already participated in ISMAR phase 1 were surveyed. Patient's demographics were the following: mean age 28.8±15.9 years, 54.4% were males; urban residence (80.9%). 30.1% reported having persistent, 32.4% intermittent, 34.9% seasonal and 14.3% perennial AR. The main co-morbidities were: sinusitis (49.6%), asthma (37.0%), conjunctivitis (34.0%), nasal polyps (12.9%) and otitis (9.7%). Allergen skin tests were positive to house-dust mites (74.8%), molds (17.5%), animal dander (18.1%), and pollens (47.7%). 89.6% of the patients had received oral anti-H1 antihistamines (Oa-H1), 64% intranasal corticosteroids (ICS), 53.2% oral/intranasal decongestants, and 3% sub-cutaneous specific immunotherapy (SCIT). The patients' preference was the following: oral route of administration, 62.2% and intranasal route 32.1%. The patients' preference medications were: Oa-H1A 86.2%; ICS 57%; nasal and oral decongestants 32.6 and 25 %, respectively. Main factors affecting treatment compliance were frequency of doses (34.6%), treatment efficacy (28.9%), cost of medication (28.7%), route of administration (25.3%), fear of adverse events (23.7%), taste (17.7%) and other (12.0%). Considering patients' education, 87.8% of them received oral information on disease and only 45.4% written advice.
Conclusions:
Oa-H1and ICS were the most widely preferred treatments for AR and were considered safe and effective. The oral route is chosen by patients. Frequency of written educational material given to patients is low. These might be taken into account to enhance treatment adherence and outcomes.
The ISMAR study was supported by Sanofi.